Value of Highly Sensitive Troponin T for Diagnosis of Acute Coronary Syndrome in Chronic Kidney Disease Patients

2017 ◽  
Vol 1 (7) ◽  
Author(s):  
M. Ashry ◽  
Osama Ibrahim ◽  
Ahmed Obiedallah ◽  
Samir Abdulhamid ◽  
Lobna Tag ◽  
...  
2021 ◽  
Vol 345 ◽  
pp. 19-20
Author(s):  
A.B. Md Radzi ◽  
R.E.F. Raja Shariff ◽  
M.H. Hamidi ◽  
H. Sani ◽  
K.S. Ibrahim ◽  
...  

2012 ◽  
Vol 28 (4) ◽  
pp. 473-479 ◽  
Author(s):  
Midori Hasegawa ◽  
Junichi Ishii ◽  
Fumihiko Kitagawa ◽  
Kyoko Kanayama ◽  
Hiroshi Takahashi ◽  
...  

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Loncaric ◽  
P Mjehovic ◽  
D Sabljak ◽  
V Vlahovic ◽  
I Vinkovic ◽  
...  

Abstract Background and aim In recent years, worse outcomes of female acute coronary syndrome (ACS) patients have been recognized. The aim was to explore gender differences in ACS in the Croatian branch of the ISACS-CT registry (NCT01218776). Methods From January 2012 to May 2018, 3066 ACS patients were enrolled; 50% (n=1539) presenting with STEMI, 35% (n=1071) with NSTEMI, and 15% (n=456) with unstable angina (UA). In-hospital mortality was defined as the primary endpoint. Results At admission women were older, more burdened with comorbidities, with a longer delay from symptom onset to admission (Figure 1), but without differences in signs and symptoms or Troponin T levels (p=0.166). During hospitalization, there were no gender difference in the administration of beta blockers, ACE inhibitors or statins in the first 24 hours. Coronary angiography was performed in a smaller percentage of female patients (86 vs. 92%, p<0.001), however, the finding of no significant stenosis was more common in women (6 vs. 2%, p<0.001). Furthermore, less women underwent primary PCI (pPCI) (67 vs. 77%, p<0.001). While there were no gender differences in the number of the treated lesions (p=0.978), women had a higher incidence of procedural pPCI complications compared to men (13 vs. 8%, p=0.001) – predominantly due to higher occurrence of no reflow, side branch loss and new thrombus formation. Multivariate regression showed gender was not associated with the decision not to perform pPCI, whereas age over 65 years (OR=1.75), diabetes (OR=1.30), hypertension (OR=1.55), chronic kidney disease (OR=2.06) and the delay from onset of symptoms to admission >6h (OR=1.61) were associated. At discharge, there were no gender differences in LV ejection fraction <40% (p=0.259). Women with STEMI had significantly higher in-hospital mortality (10 vs. 4%, p<0.001), whereas no gender differences were seen regarding unstable angina and NSTEMI. After multivariate regression, only age over 65 years (OR=3.61), chronic kidney disease (OR=1.85) and primary PCI (OR=0.49) remained associated with in-hospital mortality. Conclusion The findings in the Croatian branch of the ISACS-CT registry demonstrate notable gender differences in ACS. Older age and a substantial burden of comorbidities represent strong influences on disease development, intervention choice and in-hospital mortality when treating women with ACS. Figure 1 Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 10 (18) ◽  
pp. 4216
Author(s):  
Brunilda Alushi ◽  
Fabian Jost-Brinkmann ◽  
Adnan Kastrati ◽  
Salvatore Cassese ◽  
Massimiliano Fusaro ◽  
...  

(1) Background: Patients with severe chronic kidney disease (CKD G4–G5) often have chronically elevated high-sensitivity cardiac troponin T (hs-cTnT) values above the 99th percentile of the upper reference limit. In these patients, optimal cutoff levels for diagnosing non-ST-elevation acute coronary syndrome (NSTE-ACS) requiring revascularization remain undefined. (2) Methods: Of 11,912 patients undergoing coronary angiography from 2012 to 2017 for suspected NSTE-ACS, 325 (3%) had severe CKD. Of these, 290 with available serial hs-cTnT measurements were included, and 300 matched patients with normal renal function were selected as a control cohort. (3) Results: In the CKD cohort, 222 patients (76%) had NSTE-ACS with indication for coronary revascularization. Diagnostic performance was high at presentation and similar to that of the control population (AUC, 95% CI: 0.81, 0.75–0.87 versus 0.85, 0.80–0.89, p = 0.68), and the ROC-derived cutoff value was 4 times higher compared to the conventional 99th percentile. Combining the ROC-derived cutoff levels for hs-cTnT at presentation and absolute 3 h changes, sensitivity increased to 98%, and PPV and NPV improved up to 93% and 86%, respectively. (4) Conclusions: In patients with severe CKD and suspected ACS, the diagnostic accuracy of hs-cTnT for the diagnosis of NSTE-ACS requiring revascularization is improved by using higher assay-specific cutoff levels combined with early absolute changes.


2017 ◽  
pp. 101-106
Author(s):  
Thi Thanh Hien Bui ◽  
Hieu Nhan Dinh ◽  
Anh Tien Hoang

Background: Despite of considerable advances in its diagnosis and management, heart failure remains an unsettled problem and life threatening. Heart failure with a growing prevalence represents a burden to healthcare system, responsible for deterioration of patient’s daily activities. Galectin-3 is a new cardiac biomarker in prognosis for heart failure. Serum galectin-3 has some relation to heart failure NYHA classification, acute coronary syndrome and clinical outcome. Level of serum galectin-3 give information for prognosis and help risk stratifications in patient with heart failure, so intensive therapeutics can be approached to patients with high risk. Objective: To examine plasma galectin-3 level in hospitalized heart failure patients, investigate the relationship between galectin-3 level with associated diseases, clinical conditions and disease progression in hospital. Methodology: Cross sectional study. Result: 20 patients with severe heart failure as NYHA classification were diagnosed by The ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2012) and performed blood test for serum galectin-3 level. Increasing of serum galectin-3 level have seen in all patients, mean value is 36.5 (13.7 – 74.0), especially high level in patient with acute coronary syndrome and patients with severe chronic kidney disease. There are five patients dead. Conclusion: Serum galectin-3 level increase in patients with heart failure and has some relation to NYHA classification, acute coronary syndrome. However, level of serum galectin-3 can be affected by severe chronic kidney disease, more research is needed on this aspect Key words: Serum galectin-3, heart failure, ESC Guidelines, NYHA


Kardiologiia ◽  
2019 ◽  
Vol 59 (10) ◽  
pp. 5-13
Author(s):  
N. V. Lomakin ◽  
L. I. Buryachkovskaya ◽  
A. B. Sumarokov ◽  
Z. A. Gabbasov ◽  
A. N. Gerasimov

Aim: to assess relation ofhigh functional activity ofplatelets to prognosis ofunfavorable cardiovascular events in patients with Acute Coronary Syndrome (ACS).Materials. The study was based on the data of a single center ACS registry conducted in the Central Clinical Hospital of the Presidential Affairs Department of Russian Federation. Of 529 included patients in 425 without contraindications to double antiplatelet therapy we carried out analysis of dependence of 30 days level of unfavorable events on parameters of functional activity of platelets.Results. High on-treatment platelet reactivity (HTPR) was found to be associated with 3.5 increase of mortality in the group of patients with high cardiovascular risk. Logistic model of prognosis of unfavorable events based on multifactorial analysis of data from patients with measured platelet aggregation included chronic kidney disease, type of myocardial infarction, and degree ofplatelet aggregation >45%. C -statistic was equal to 0.77. We also present in this paper discussion of problems related to studying approaches to individualization of anti-aggregation therapy in real clinical practice and problems of organization ofsimilar studies.Conclusion. The study showed that patients with ACS increased platelet aggregation, as well as chronic kidney disease and type 2 MI are associated with a 30 day prognosis of adverse events.


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